Taking stock 20 years after the
discovery of AIDS
Marcela Villarreal, Chief of the Population Programme Service and FAO focal point for AIDS, answers questions about the Special Session and the situation in the hardest hit countries:
Villarreal, FAO's focal point for HIV/AIDS
Marcela Villarreal, FAO's focal point for HIV/AIDS (FAO/G.Diana)
We are exactly 20 years after the first clinical evidence of AIDS was reported. At that time it was seen as a troubling health issue. Today we know that it can affect every aspect of development. It has become a major development crisis.Without a concerted effort from government, civil society, NGOs and the international community we will not be able to address the consequences. The Special Session is about consolidating this awareness and promoting adequate national leadership in the fight against the disease.
Is AIDS a health issue or a development issue?
When less than one percent of the population is affected, the effect is mostly at the household level and we can say that it is mainly a health problem, appropriately dealt with by the Ministry of Health. After a certain proportion of the population is affected, HIV/AIDS becomes a development problem and all sectors need to be involved in a co-ordinated response. The Ministry of Agriculture plays a very important role in this response, given that in the most affected countries up to 80 percent of the population depends on agriculture. Who would have thought 20 years ago that AIDS could become a threat to development and to the very fabric of society, as we see now in places like sub-Saharan Africa? In the most-affected communities whole age groups have been wiped out and large proportions of children are orphans. Children are not receiving the basic skills and knowledge that will allow them to become productive members of society.
FAO's mandate covers food security and rural development. What are your member countries saying to you about HIV/AIDS?
Member countries asked us during our recent Committee on World Food Security meeting to take a more profound look at the impact of AIDS on food security, studying how the disease affects men and women, human rights and the vicious circle of poverty, food insecurity and HIV/AIDS. Our members want FAO to measure and monitor the impact of the epidemic on food security.
Does the disease affect men and women differently?
The disease certainly adds to rural women's workload, as women are the traditional care-givers when people are sick and when city-dwellers get ill with AIDS they tend to return to their village of origin. Biological and social factors make women more vulnerable to HIV, especially in youth and adolescene. In many places HIV infection rates are three to five times higher in young women than in young men. During the initial stages of the epidemic more men tend to be infected, but later on the proportions of women become higher. In sub-Saharan Africa 55 percent of persons living with HIV/AIDS are women but at the world level HIV-positive men are more numerous. As of December 2000, there were 18.3 million men in the world living with HIV/AIDS compared to 16.4 million women.
How does the disease affect food security?
Now we have a clearer picture of how HIV/AIDS impacts food security at the household, community and national level. It affects households' ability to produce food, because the AIDS death toll is highest among people in the productive age groups. It creates a shortage of labour, very strongly felt among agricultural workers. Knowledge about farming methods can be lost when they die. The disease impoverishes families, limiting their ability to buy food. When everyone in the community has someone ill with AIDS, the community's ability to produce and buy food is affected as neighbours become too overburdened to help each other with food, loans or a hand in the fields. Finally, at the national level, HIV/AIDS affects countries' ability to import food: the disease has reduced GDP growth per capita by an estimated one percent per capita annually in Africa.
How is FAO responding to the threat?
We are an institution that deals mainly with hunger and rural development. Because of the impact of HIV/AIDS on these two related issues, the Organization is making sure that the disease is adequately taken into account in all of its relevant areas of work. Many times this requires rethinking our approach. For example, we want to make sure that in AIDS-affected rural areas, agricultural activities will be adapted to the changing conditions. We need to re-think the agricultural policy we promote. We want to make sure we are not promoting crops that need a lot of farm labour. Needs are changing for agricultural extension as parts of the population die and even the extension officers succumb to the disease. Agricultural extension must change to serve those who are left to farm, such as orphans and the elderly.
What about preventing the spread of the disease?
Rural people in developing countries, who traditionally have poor access to information and low literacy levels, are more vulnerable to contracting HIV. FAO is experimenting in southwest Cambodia with using existing networks of farmers for AIDS education. The method is based on the Farmer Field School model, in which networks of farmers learn about safe methods to defend their crops from pests. Now the farmers have formed Farmer Life Schools, where they have adopted similar analytical methods to learn about human behaviour and AIDS prevention. This group approach empowers rural people, allowing them to solve their problems in their own way.
For more information contact Marcela Villarreal, FAO's focal point for HIV/AIDS (firstname.lastname@example.org)
25 June 2001